The dilemma in the October issue concerned an eight-year-old cow that became acutely recumbent a day after being admitted to hospital, but it remained alert and with a normal appetite. The cow had originally been brought in for treatment of chronic diarrhoea, but had briefly fallen while getting onto the trailer. Based on a poor prognosis, euthanasia was recommended for the recumbency, but the farmer insisted that it be managed supportively and, after five weeks, the cow eventually did rise without assistance and was discharged. (In Practice, October 2013, volume 35, pages 542-543). Fabienne Uehlinger commented that such unique situations are outliers', which don't fit neatly within the guidance on case management that is provided by formal evidence-based veterinary medicine. In cases where there was limited literature on the subject, as with alert cows with prolonged recumbency, she argued that vets should continue to rely on their knowledge and experience in order to critically consider the particular circumstances or each case. Siobhan Mullan is a research fellow at the University of Bristol with interests in practical welfare assessment and animal ethics. She holds the RCVS diploma in animal welfare science, ethics and law.